Let’s get physical

Time Out Kids spoke to Marilyn Lopes Biller, Chartered Physiotherapist specialising in children’s and women’s health at Kuur Physiotherapy Center to find out how physio can be of benefit during pregnancy, and after for your baby

Physiotherapy is most often associated with rehabilitation from surgery or sports injuries – what services can be of benefit to mums to be?During pregnancy, the body goes through drastic changes and weight gain in a short time. Physiotherapy can help the body in preparing and coping throughout this metamorphosis. Pregnant women are often told for example that it is normal to have back pain. Well it is not unusual, as three quarters of women do suffer from back pain, but it absolutely not normal - it can be avoided and treated successfully.

When should pregnant women seek out your services and what should they expect when they come to the clinic?The majority of women make their first visit around their second trimester of their pregnancy. There are different primary motivations - wishing to exercise safely and under professional supervision, getting ready for labour and delivery with their partner through jointly participating in our Active Birthing Workshop, or because they are restricted in exercising and aren’t able to join a general antenatal group. I cannot emphasise enough how important it is to exercise during pregnancy, both for the mother and the baby.

From a Physio point of view, is there anything specific post birth that women might not normally take much notice of that they should seek physio for?There are always thousands of reasons not to take care of your body after your baby is born, however, you need to think of yourself and your own future. Physiotherapy can help you recover a healthy and strong back quickly, a flat stomach safely, and also reinforce your pelvic floor. Whilst you might not have a current issue, or might neglect to pay sufficient attention to this topic for a while, this needs your care and attention at this stage to avoid future problems with incontinence and organ descent at a later stage in your life.

Can you be of any assistance to women who are recovering from a caesarean? Yes, C-section can lead to a variety of issues with the most obvious one being the direct effect on the muscle and healing process for the scar. The abdominal muscles will be weaker because they still need to heal. The less obvious effects, are those relating to the pelvic joints and the pelvic floor. We can respond to and assist with these issues through our various techniques.

What services do you offer for children and from what age can kids come to the practice?Paediatric physiotherapists work with newborns and children up to 17 years old.

We can help at an early age with congenital and perinatal orthopaedic problems including flat head, club foot etc. Usually babies with colitis respond very well to baby massage too. Chest Physiotherapy is used for babies and children with chest congestion. We also treat common injuries, such as sprains, strains and can assess any abnormality in physical development of a child and their walking pattern.What should a parent expect if they have a concern and wish to bring their child to you for? Usually before coming to a Physiotherapist the parent would have received a first opinion from their Paediatrician or GP and assessment and any treatment will then depend on the problem. For a sports injury or a minor injury, muscle, tendon and joint assessments will be made whereas for chest congestion, we listen to the lungs. While assessing for development delay, the Physiotherapist will monitor the child’s capabilities to lift and maintain their head, their level of responsiveness when unbalanced and so on. Each baby has their own path of development - some will be earlier, while others will take their time. There might also be some stages that will never appear, such as crawling. It is possible for a baby to go from creeping to walking - without crawling. This is not a sign of development delay.

From the point of view of a Physiotherapist, is there anything that parents may not be aware of that they should keep an eye out for as their child grows?Look out for changes in behaviour during the first three years of life. You should seek medical advice if you see that your baby used to do something, but all of the sudden seems not to do it anymore, or isn’t capable of doing it anymore. This could be that your baby has some difficulty to hold their head, appears more floppy, or quite the contrary, has vivid abnormal actions with their hand or leg, or keeps one or both of their legs straight.

Sometimes parents cannot tell me when their baby started grasping. This is one of the major development stages - it as important as walking, or the change of grasping from full hand to bi-digitally. This keystone that will permit precision and finesse of the movement, and later will allow writing, painting and expressing themselves. I ask parents to observe and celebrate these as they would do with the first step, or successful potty training!